Provider Demographics
NPI:1417318973
Name:RUTHERFORD, KATHERINE ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ANN
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FIFTH AVENUE
Mailing Address - Street 2:APT 1202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8821
Mailing Address - Country:US
Mailing Address - Phone:917-523-3251
Mailing Address - Fax:
Practice Address - Street 1:24 FIFTH AVENUE
Practice Address - Street 2:APT 1202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8821
Practice Address - Country:US
Practice Address - Phone:917-523-3251
Practice Address - Fax:212-463-0220
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730841031041C0700X
NY084103-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical